'This Week' Transcript: Karl Rove and David Plouffe

March 21, 2010

Page 12 of 16

And from the standpoint of this bill, changing America, which a lot
of the opponents say, Trent, you can still have your own doctor, just as
you have now. You have a health care plan you like now? You can still
have it.

LOTT: What if the doctor says, no, I'm not going to take anymore
Medicaid patients or I'm not going to take any more Medicare patients?
And that's already beginning to happen.

DASCHLE: But they're -- but they're doing that now. And the status
quo is simply unsustainable. We can't sustain the cost, we can't
sustain the problems with regard to quality. We can't sustain virtually
any aspect of health care as it's now delivered in this country.

LOTT: And, by the way...

(CROSSTALK)

LOTT: Let me jump in here with this, too. You mentioned Medicare
and Social Security, both very popular, very important parts of our
fabric in America, but both of them are in financial difficulty. Here
we are, putting more weight on Medicare at a time when it's already
facing tremendous problems because of the baby boomers that are coming
along.

DONALDSON: But George is quite correct. Because of the demography
of the country and the way it's changing, yes, we have to fix these
things.

LOTT: When are we going to do it?

DONALDSON: Well, you're going to do it because you have to do it as
we go along.

LOTT: We've been having to do it for the last 10 years. We didn't
do it.

DONALDSON: That's right. And we fixed Social Security, apparently,
in the early '80s. We had to fix it again. We may have to fix it down
the line, Trent, but that's no reason to abandon it or abandon this kind
of health care.

WILL: Tom talks about costs. One of the first and most predictable
consequences of this bill is going to be that health insurance premiums
are going to go up. They have to, Tom. We're changing the risk pool.

Once you say to people -- to insurance companies that they cannot
discriminate against people who have pre-existing conditions, then when
you bring the risk pool in, all these people who already have troubles,
you're going to have the premiums go up. That's the first...

(CROSSTALK)

KARL: But it's also requiring you to have insurance...

(CROSSTALK)

DASCHLE: But George is right about premiums. I mean, there --
there -- there are issues involving premium, but what he hasn't
mentioned is the increased transparency, the fact that we're finally
going to get away from rewarding volume. We're going to start rewarding
value.

We're going to have delivery reform for the first time. We're going
to be dealing with the structural problems in our health care system for
the first time in history. And those are, by -- again, by CBO account,
going to have a profound effect in bringing costs down, not -- not
raising them.

LOTT: Let me make one other point here. I know process in
Washington consumes us, and the average American out there is saying,
"What is all this?" But I have never seen such a contorted process to
try to get a bill through the House, through the Senate. They talked
about just deeming the bill passed. At least they were wise enough
yesterday to back away from deem and pass, even though you didn't vote
on it, and now it's going to go back to the Senate for reconciliation.
Now, I used reconciliation, but not like this.